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Objective <p>Patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) frequently exhibit heightened systemic inflammation, oxidative stress, and cardiopulmonary dysfunction, contributing to an increased risk of recurrent exacerbations. The lactate dehydrogenase-to-albumin ratio (LAR) is a readily available biomarker reflecting inflammatory and metabolic stress; however, its association with the frequent-exacerbator phenotype in patients with COPD and CHD remains unclear. This study aimed to evaluate the relationship between admission LAR levels and frequent exacerbations in this high-risk population.</p> Methods <p>This retrospective study analyzed 489 hospitalized patients with acute exacerbations of COPD (AECOPD) and comorbid CHD. Patients with two or more exacerbations were classified as frequent exacerbators. Demographic characteristics, comorbidities, and lab parameters were collected. Multivariable logistic regression and restricted cubic spline analyses were performed to evaluate the association between LAR and the frequent-exacerbator phenotype.</p> Results <p>A total of 489 patients with AECOPD and CHD were included, with a mean age of 76&#xa0;years, and 66.9% were male. Higher admission LAR levels were significantly associated with the frequent-exacerbator phenotype in the unadjusted analysis (Odds Ratio [OR] 1.23; 95% confidence interval [CI] 1.12 ~ 1.35; <i>p &lt;</i> 0.001). The association remained significant after adjustment for potential confounders (adjusted OR 1.34; 95% CI 1.19 ~ 1.51; <i>p &lt;</i> 0.001). Restricted cubic spline analysis demonstrated a significant nonlinear association (<i>p =</i> 0.004), with an inflection point at a LAR value of approximately 5.1 (OR 4.04, <i>p =</i> 0.001), whereas a more modest increase was observed above this threshold (OR 1.45, <i>p =</i> 0.009).</p> Conclusion <p>Higher admission LAR levels were independently associated with the frequent-exacerbator phenotype among patients with AECOPD and CHD. This readily available biomarker may improve risk stratification and personalized management in this high-morbidity population.</p>

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The lactate dehydrogenase-to-albumin ratio predicts frequent exacerbations in COPD patients with coronary heart disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • HongXu Zhang,
  • MengYu Lian,
  • Jie Song,
  • JingJing Yang,
  • RuiYan Lin,
  • JinXiang Wang

摘要

Objective

Patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) frequently exhibit heightened systemic inflammation, oxidative stress, and cardiopulmonary dysfunction, contributing to an increased risk of recurrent exacerbations. The lactate dehydrogenase-to-albumin ratio (LAR) is a readily available biomarker reflecting inflammatory and metabolic stress; however, its association with the frequent-exacerbator phenotype in patients with COPD and CHD remains unclear. This study aimed to evaluate the relationship between admission LAR levels and frequent exacerbations in this high-risk population.

Methods

This retrospective study analyzed 489 hospitalized patients with acute exacerbations of COPD (AECOPD) and comorbid CHD. Patients with two or more exacerbations were classified as frequent exacerbators. Demographic characteristics, comorbidities, and lab parameters were collected. Multivariable logistic regression and restricted cubic spline analyses were performed to evaluate the association between LAR and the frequent-exacerbator phenotype.

Results

A total of 489 patients with AECOPD and CHD were included, with a mean age of 76 years, and 66.9% were male. Higher admission LAR levels were significantly associated with the frequent-exacerbator phenotype in the unadjusted analysis (Odds Ratio [OR] 1.23; 95% confidence interval [CI] 1.12 ~ 1.35; p < 0.001). The association remained significant after adjustment for potential confounders (adjusted OR 1.34; 95% CI 1.19 ~ 1.51; p < 0.001). Restricted cubic spline analysis demonstrated a significant nonlinear association (p = 0.004), with an inflection point at a LAR value of approximately 5.1 (OR 4.04, p = 0.001), whereas a more modest increase was observed above this threshold (OR 1.45, p = 0.009).

Conclusion

Higher admission LAR levels were independently associated with the frequent-exacerbator phenotype among patients with AECOPD and CHD. This readily available biomarker may improve risk stratification and personalized management in this high-morbidity population.